Implant for osteosynthesis

ABSTRACT

An implant for osteosynthesis, for example a bone nail, has an implant body which has at least one bore with a threaded portion and a bone screw which engages the thread when it is threaded into a bone for the fixation of the implant body. The threaded bore has an annular groove the diameter of which is larger than the thread outer diameter, and which receives a ring of a deformable material with an inner diameter which is smaller than the outer diameter of the thread of the bone screw so that the ring extends partially into the bore.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a continuation of U.S. application Ser. No.12/754,025, filed on Apr. 5, 2010, which is a continuation of U.S.application Ser. No. 11/810,180, filed on Jun. 5, 2007 which is acontinuation of U.S. application Ser. No. 10/755,815, now U.S. Pat. No.7,247,157, filed on Jan. 12, 2004, the disclosures of which areincorporated herein by reference.

BACKGROUND OF THE INVENTION

It is generally known to fix plates to bone by means of bone screws forthe repair of bone fractures. Further, it is well known to configurebone screws for use with so-called interlocking nails for the care offractures of tubular bones. Interlocking nails have cross-bores for thereception of bone screws or interlocking screws at both the distal andproximal nail ends. It is known to provide the bores with a thread forthe reception of a bone screw. In most cases, the thread is a so-calledcortical thread, i.e. a thread corresponding to the thread of the bonescrew. This thread has the advantage that it impedes the postoperativemigration of the bone screws.

It is known to configure nails for the repair of humeral fractures asinterlocking nails and to provide several cross-bores in the proximalportion of the interlocking nail which are offset from each other in thecircumferential direction and extend obliquely to the axis of the nail,if required. A nail having oblique cross-bores is shown in U.S. Pat. No.5,472,444. The emigration of interlocking screws is critical and, thus,is a particular problem in a humeral fracture.

BRIEF SUMMARY OF THE INVENTION

It is one object of the invention to provide an implant forosteosynthesis that efficiently prevents the postoperative migration ofbone screws.

In the inventive implant, the threaded bore has an annular groove thediameter of which is larger than the thread outer diameter, and whichreceives a ring of a deformable material with an inner diameter which issmaller than the outer diameter of the thread of the bone screw. Thus,the ring has a portion which extends into the threaded bore.

According to the invention, the ring is preferably made of a plasticmaterial, e.g. polyethylene. After insertion into the annular groove thering blocks some portion of the thread cross-section and, while the bonescrew is turned in, the ring is deformed so as to produce a frictionalengagement between the bone screw, the ring and the annular groove, thatprevents the bone screw from turning out by itself.

Moreover, the ring centers the bone screw in the threaded bore so thatan increased angular stability of the bone screw is achieved in theimplant as compared to that of the non-secured design.

The bores in the implant usually have an inlet end and an outlet end.According to an aspect of the invention, the annular groove is disposedadjacent to the outlet end. According to another aspect of theinvention, the bore portion between the outlet end and annular groovepreferably is non-threaded. According to an aspect of the invention, thebore portion adjacent to the inlet end is also non-threaded. Thearrangement of the ring at the outlet side of the through bore ensuresthat the screw is already in a threaded engagement when it strikes thering. Here, the mostly conical tip of the bone screw urges the ring intothe groove before the ring of the bone screw undergoes deformation. Thisensures that the interlocking screw does not force the ring out of thebore.

According to another aspect of the invention, the annular groove isrectangular in cross-section with the ring exhibiting a complementarycross-section. However, it is preferred that the width of the ring besomewhat smaller than the width of the annular groove. This allowseasier insertion of the ring into the annular groove. Also, this createsa clearance for an axial deformation of the ring.

According to another aspect of the invention, the ring is split and theends of the ring are at a distance from each other when the ring is in arelaxed state. During its insertion, the ring may be slightly contractedradially to enable it to be inserted into the annular groove without aproblem. Preferably, the two inside edges of the ring are chamfered toprevent the ring from being forced out of the groove. Basically, itwould be sufficient to chamfer the edge facing the inlet end, but sinceit is desired that the orientation in which the ring is inserted intothe groove does not matter it is preferred to form both inner edges witha chamfer.

The outer diameter of the ring, when in a relaxed state, is slightlylarger than the diameter of the annular groove. This causes the ring tobe retained by itself in the groove, i.e. also during transport andwhile the implant is handled before the bone screw is turned in.

The invention is applicable to any implants that are inserted incombination with bone screws. The invention is specifically preferredfor use with an intramedullary implant, e.g. a bone nail, preferably aninterlocking nail. It is particularly preferred to apply it to a humeralnail, the proximal end of which has three or more cross-bores the axesof which are offset from each other in a circumferential direction.

BRIEF DESCRIPTION OF THE DRAWINGS

The invention will be described in more detail below with reference toan embodiment shown in the drawings.

FIG. 1 shows a cross-section of the proximal end of the humeral nailwith securing rings according to the invention in a perspective view;

FIG. 2 shows a longitudinal section through a humeral nail with athreaded bore, a groove and a securing ring according to the invention;

FIG. 3 shows the front view of a securing ring of FIG. 1 or 2; and

FIG. 4 shows a section through the ring of FIG. 3 along the line 4-4.

DETAILED DESCRIPTION

Referring to FIG. 1 there is shown a humeral nail 10 having four offsetcross-bores and having a longitudinally sectioned proximal portion 12.As can be seen, the preferred proximal portion 12 is provided with fourcross-bores 14, 16, 18 and 20 which, in the preferred embodiment areoffset from each other in the axial and circumferential directions andare at an angle from the longitudinal axis 21 of nail 10. In thepreferred embodiment, bores 14, 16, 18 and 20 are configured as threadedbores. FIG. 1 further shows that bores 14, 18 and 20 receive a securingring 22, 24 and 26, respectively. If desired, bore 16 can also include asecuring ring. These rings serve for securing an interlocking screw 28which has a head 30 and a shank 32 with thread 34. In the preferredembodiment thread 34 is a cortical thread which is useful in ensuring afixed seating in the bone without unnecessarily imposing a stress on thebone. The preferred thread 34 is a flat thread which threadably engagesthe thread in the threaded bores 14, 16, 18 and 20.

FIG. 2 illustrates a single threaded bore, e.g. the threaded bore 14.This bore is typical of the other threaded bores of the preferredembodiment. Bore 14 has an inlet end 36 and an outlet end 39. Therefore,during use conical tip 38 of interlocking screw 28 shown in FIG. 1 isintroduced into the inlet end 36 which has an inlet conical taper orcountersink 40 as can be seen at end 36. In the preferred embodiment,countersink 40 is joined by a non-threaded bore portion 42. This isfollowed by threaded portion 44. Portion 44 has at its end formedtherein an annular groove 46 of a rectangular cross-section in whichsecuring ring 22 is received. Again, in the preferred embodiment,non-threaded portion 48 is located towards outlet end 39. As can be seenthe width of ring 22 is somewhat smaller than the width of annulargroove 46.

Preferred ring 22 is illustrated in somewhat more detail in FIGS. 3 and4. As can be seen in the preferred embodiment, ring 22 is split and ends50, 52 are provided with a slope at an angle of 45° are spaced a certaindistance from each other. The inside edges of ring 22 are provided withchamfer 54 and 56, respectively. The outer diameter of ring 22, when ina relaxed state, is slightly larger than the diameter of annular groove46. In the preferred embodiment, the inner diameter of the ring issmaller than the outer or major diameter of threaded portion 34, but islarger than the inner or minor diameter of threaded portion 34 of screw28.

While being inserted, ring 22 is somewhat compressed circumferentiallyso that it can be readily introduced into annular groove 46. Afterinsertion into groove 46, ring 22 will relax and expand to a smallextent after insertion, but not up to its fully expanded diameter in therelaxed state. This results in the ring being retained in the annulargroove 46 to a fairly reliable degree.

When an interlocking screw 28 is introduced into bore 14 from inlet end36, threads 44 and 34 engage each other before thread 34 interacts withsecuring ring 22. Conical tip 38 of interlocking screw 28 initiallyurges securing ring 22 radially outwardly before thread 34 interactswith securing ring 22 so that forcing ring 22 out of the bore isavoided. The ring, which is made of an elastic plastic material, isdeformed accordingly and frictional engagement is produced betweenthread 34 and ring 22 and between ring 22 and annular groove 46, theresult obtained being that screw 28 is efficiently secured in bore 34.

Although the invention herein has been described with reference toparticular embodiments, it is to be understood that these embodimentsare merely illustrative of the principles and applications of thepresent invention. It is therefore to be understood that numerousmodifications may be made to the illustrative embodiments and that otherarrangements may be devised without departing from the spirit and scopeof the present invention as defined by the appended claims.

1. An implant for osteosynthesis, comprising a bone nail having a bodywhich has at least one cross-bore with a threaded portion and a bonescrew which engages the threaded portion when it is threaded into a bonefor the fixation of the implant body, wherein the cross-bore has acircumferential recess the diameter of which is larger than an outerdiameter of the thread and a ring of a deformable material for insertioninto the circumferential recess, the ring having an inner diameter whichis smaller than the outer diameter of the thread of the bone screw,wherein the bore has a screw inlet end and a screw outlet end and thecircumferential recess is located between the threaded portion and theoutlet end, the circumferential recess located in the bore such that thebone screw engages the threaded portion before contacting the ring,wherein a cylindrical bore portion between the annular recess and theoutlet end is non-threaded, further including a non-threaded conicallytapered bore portion adjacent to the inlet end.
 2. The implant as setforth in claim 1 wherein the non-threaded portions are of a diameterwhich is slightly larger than the outer diameter of the bore thread. 3.The implant as set forth in claim 1 wherein the circumferential recessis rectangular in cross-section.
 4. The implant as set forth in claim 1wherein the ring is a split-ring formed from a resiliently yieldingplastic.
 5. The implant as set forth in claim 4 wherein the ends of thesplit ring are spaced from each other when it is in a relaxed state. 6.The implant as set forth in claim 5 wherein the ends of the ring are atan oblique angle and have the same angle of inclination.
 7. The implantas set forth in claim 1 wherein a ring inner diameter has edges whichhave a chamfer.
 8. The implant as set forth in claim 1 wherein the ringhas a width which is slightly smaller than a width of thecircumferential recess.
 9. The implant as set forth in claim 8 whereinan outer diameter of the ring, when in a relaxed state, is slightlylarger than a maximum diameter of the circumferential recess.
 10. Theimplant as set forth in claim 1 wherein the bone nail is an interlockingnail.
 11. The implant as set forth in claim 1 wherein the nail is ahumeral nail, a proximal end of which has a plurality of cross-bores,the cross-bores each extending along an axis which are offset from eachother in a circumferential direction.
 12. The implant as set forth inclaim 11 wherein the implant has at least two cross-bores having acircumferential recess including a ring of deformable material.
 13. Theimplant as set forth in claim 1 wherein the circumferential recess is anannular groove having a rectangular cross-section and extends in a planeperpendicular to a central axis of said cross-bore.
 14. The implant asset forth in claim 13 wherein an inner portion of said ring has edgeswhich have a chamfer.
 15. The implant as set forth in claim 14 whereinan outer diameter of the ring, when in a relaxed state, is slightlylarger than a maximum diameter of the annular groove.
 16. The implant asset forth in claim 1 wherein the non-threaded bore portion at the inletend is a counterbore.
 17. A bone fracture fixation implant comprising: abone nail having a body extending along a longitudinal axis and havingat least one partially threaded bore extending in a direction transverseto the longitudinal axis, the at least one bore extending along an axiswhich is offset from another bore in a circumferential direction aboutthe longitudinal axis, the at least one bore having an inlet end and anoutlet end, the at least one bore having an inner surface with acircumferential recess formed therearound, the recess having one sideopen to the bore with the bore having a conically tapered non-threadedportion between the inlet end and the threaded portion; a plastic ringmounted in the groove having an inner portion extending from the saidone side of the circumferential recess into the bore; and a bone screwhaving a threaded outer diameter engageable with the inner portion ofthe ring upon insertion into the at least one bore, the circumferentialrecess located in the bore such that the bone screw contacts the plasticring after the bone screw engages the threaded portion.
 18. The implantas set forth in claim 17 wherein the bone nail is a humeral nail. 19.The implant as set forth in claim 17 wherein the non-threaded portionsare of a diameter which is slightly larger than the outer diameter ofthe bore thread.
 20. The implant as set forth in claim 17 wherein thecircumferential recess is an annular groove having a rectangular incross-section.
 21. The implant as set forth in claim 1 wherein the ringis a split-ring formed from a resiliently yielding plastic.
 22. Theimplant as set forth in claim 20 wherein the ends of the split ring arespaced from each other when it is in a relaxed state.
 23. The implant asset forth in claim 22 wherein the ends of the ring are at an obliqueangle and have the same angle of inclination.
 24. The implant as setforth in claim 17 wherein a ring inner diameter has edges which have achamfer.
 25. The implant as set forth in claim 17 wherein the ring has awidth which is slightly smaller than a width of the circumferentialrecess.
 26. The implant as set forth in claim 25 wherein an outerdiameter of the ring, when in a relaxed state, is slightly larger than amaximum diameter of the circumferential recess.
 27. The implant as setforth in claim 17 wherein the bone nail is an interlocking nail.
 28. Theimplant as set forth in claim 17 wherein the nail is a humeral nail, aproximal end of which has a plurality of cross-bores, the cross-boreseach extending along an axis which are offset from each other in acircumferential direction around the nail.
 29. A bone nail comprising abody which has at least one bore with a threaded portion and a bonescrew which engages the threaded portion when it is threaded into a bonefor the fixation of the implant body, wherein the bore has acircumferential recess a diameter of which is larger than an outerdiameter of the thread and a ring of a deformable material for insertioninto the circumferential having an inner diameter which is smaller thanthe outer diameter of the thread of the bone screw, wherein the bore hasa screw inlet end and a screw outlet end, wherein a cylindrical boreportion between the circumferential recess and the outlet end isnon-threaded and further including a non-threaded conically tapered boreportion adjacent to the inlet end, the circumferential recess located inthe bore such that the bone screw engages the threaded portion beforecontacting the ring.
 30. The implant as set forth in claim 17 whereinthe non-threaded bore portion at the inlet end is a counterbore.
 31. Abone nail, comprising a body which has at least one bore extending alonga central axis with a threaded portion and a bone screw which engagesthe threaded portion when it is threaded into a bone for the fixation ofthe implant body, wherein the bore has an circumferential recess andouter diameter of which is larger than an outer diameter of the threadand a ring of a deformable material for insertion into the recess, thering having an inner diameter which is smaller than the outer diameterof the thread of the bone screw, the diameters measured from the borecentral axis, wherein the bore has a screw inlet end and a screw outletend and the circumferential recess is disposed closer to the outlet endthan the inlet end, wherein a cylindrical bore portion between thecircumferential recess and the outlet end is non-threaded, thecircumferential recess located in the bore such that the bone screwengages the threaded portion before contacting the ring.